The dynamics of Borderline Personality Disorder

Recent reasoning in psychopathology sees mental disorders as phenomena that emerge, at least in part, from complex patterns of symptom-symptom interactions. Borderline Personality Disorder (BPD) is characterized by instability of self-image, interpersonal relationships, and affects, as well as by marked impulsivity. In this study, we investigated the dynamical interplay of BPD symptoms over time. We employed an Ecological Momentary Assessment (EMA) protocol assessing BPD symptoms five times a day for 31 days in a sample of 156 participants. Participants also completed a comprehensive assessment of personality, including BPD, before the EMA, after the EMA, and one month later. We examined BPD symptoms at two timescales: The short scale of EMA and the long scale offered by the three questionnaires. At the short timescale, we employed a multilevel vector auto-regressive network model, which provided insights into the contemporaneous and cross-lagged relationships among symptoms. At the long timescale, we observed a decrease in all BPD symptoms immediately after EMA and after one month, suggesting beneficial effects of the self-reflection induced by EMA. We discuss how each analysis gave unique insights into the dynamics of BPD.